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There is a lot of variation in health outcomes when it comes to individual states in America. Some states, such as Hawaii, have the life expectancy equivalent to that of developed countries, whereas states like Mississippi have the life expectancy equivalent to that of third world countries. This raised the questions of which states are doing well in health and why, and if their health has to do with their performance in the primary, secondary, tertiary, and/or quaternary prevention levels. The purpose of this research was to investigate if there is a correlation between performance in any of the prevention levels and the overall health status of a state, and if there is, which prevention level would be most beneficial for states to prioritize. The hypothesis of this research was: states that prioritized primary and secondary levels of prevention would have better health than states that prioritized tertiary and quaternary levels of prevention, since basic health measures contribute more to health outcomes than advanced medicine. To investigate this question, indicators were chosen to derive the ranking of each state in health and each of the four prevention levels. Six states were then chosen to represent the high, average, and low health statuses respectively. The six states were ranked for all indicators, and the data was analyzed and compared to determine a potential relationship between the prevention level rankings and the overarching health ranking. It was found that there is a correlation between performance in the primary and secondary prevention levels and a state’s overall health status, whereas there was no such correlation for the tertiary and quaternary levels. A model for health was proposed for states looking to improve their health status, which was to invest in primary prevention, followed by secondary, tertiary, then quaternary prevention and only moving to the next prevention level once the previous level reached a satisfactory threshold.
The purpose of this study is to examine the social and communicative barriers LGBTQIA+ students face when seeking healthcare at campus health and counseling services at Arizona State University. Social barriers relate to experiences and internalizations of societal stigma experienced by sexual and gender minority individuals as well as the anticipation of such events. Communication between patient and provider was assessed as a potential barrier with respect to perceived provider LGBTQIA+ competency. This study applies the minority stress model, considering experiences of everyday stigma and minority stress as a predictor of healthcare utilization among sexual and gender minority students. The findings suggest a small but substantial correlation between minority stress and healthcare use with 23.7% of respondents delaying or not receiving one or more types of care due to fear of stigma or discrimination. Additionally, communication findings indicate a lack of standardization of LGBTQIA+ competent care with experiences varying greatly between respondents.